2025 Client Tax Intake Form

Were you referred?*

YesNo

Referrer's Name

Which Tax Preparer are you working with?*

Are you a returning client?*

YesNo

Full Legal Name*

First NameLast Name

Date of Birth*

Date

Social Security Number*

Phone Number*

Please enter a valid phone number.

Email Address*

example@example.com

Current Address*

Street Address

Street Address Line 2

CityState / ProvincePostal / Zip CodeCountry

Can someone else claim you as a dependent?*

YesNo

Filing Status (as of December 31)*

Spouse Full Legal Name

First NameLast Name

Spouse Date of Birth

Date

Spouse Social Security Number

Spouse Occupation

Do you have dependents to claim?*

YesNo

How many dependents?

Dependent Information

If requested by the IRS, do you have documentation (i.e. receipts, records) to substantiate your eligibility for the Child Tax Credit, Earned Income Tax Credit and/or Head of Household Filing Status?*

YesNo

Dependent Document Uploader (Birth Certificate, Social Security Card, School records and etc.)

Select all income types received*

Upload ALL income documents (W-2s, 1099s, etc.)*

Business Name

Business Type

Sole ProprietorLLCPartnershipCorporation

EIN (if applicable)

Select applicable deductions

Upload supporting documents (1098-T, daycare statements, receipts)

Preferred Refund Method*

Direct DepositPaper Check

Bank Name

Routing Number

Account Number

Do you have an IRS IP PIN?*

YesNo

IRS IP PIN

Did you have healthcare marketplace insurance for tax year 2024?*

YesNo

Upload Form 1095A (if applicable)

Did you file taxes for tax year 2024?*

YesNo

Have you received IRS notices?

YesNo

Do you or your spouse owe child support or any unpaid taxes to the IRS?*

YesNo

Upload IRS notices (if applicable)

Upload Government Photo ID*

Upload Social Security Card*

Upload Proof of Address*

Do you consent to all preparation and filing fees associated with your 2025 tax filing?*

YesNo

I acknowledge that all information provided to Taxx Network LLC is true and accurate to the best of my knowledge. I understand that I am required to have any supporting documentation to validate the information provided. Furthermore, I understand that knowingly providing false information on my tax return and reporting it to the IRS, that I am taking part in a potentially criminal penalty situation and is punishable by law including but not limited to: facing court dates, restitution, and possible imprisonment. I waive Taxx Network LLC and the preparer of any error due to incorrect information provided by me. By signing below, I authorize Taxx Network LLC to file my tax return. I acknowledge by signing this form if I and/or my spouse owes a federal/government debt such as IRS, child support, student loans etc., I/we are still responsible for tax preparation fees due to Taxx Network LLC at the time of service. Also, if the federal refund amount is mailed, I/we are still responsible for the tax preparation fees stated on the invoice. If the tax preparation fees are not paid, I understand Taxx Network LLC will take legal action to collect the unpaid tax preparation fees and criminal charges will be filed.

Client Signature*

Spouse Signature

Date*

Date